Short-term mechanical circulatory support devices

Introduction

Percutaneous mechanical circulatory support (MCS) devices have progressed significantly since the intra-aortic balloon pump (IABP) was introduced in the 1960s 11. Kantrowitz A, Tjonneland S, Freed PS, Phillips SJ, Butner AN, Sherman JL Jr. Intraaortic balloon pumping. JAMA. 1968;203:988. Link. Although IABP is still the most commonly used short-term MCS device, it only offers modest haemodynamic support and recent studies have failed to show efficacy in large acute myocardial infarction with or without cardiogenic shock 22. Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Fuhrmann J, Böhm M, Ebelt H, Schneider S, Schuler G, Werdan K. Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock. N Engl J Med. 2012;367:1287-1296. Link. Several percutaneous MCS devices have been introduced into clinical practice challenging the role of IABP. MCS devices such as Impella® (Abiomed Inc., Danvers, MA, USA) and extracorporeal membrane oxygenation (ECMO) have the ability to provide a greater level of haemodynamic support.

Short-term MCS devices can be used in a variety of clinical settings, including prophylactic insertion for high-risk percutaneous coronary intervention (PCI), management...